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IN  ABSENTIA," 


BV 


J.  FOSTER  FLAGG,  D.  D.  8., 


PHILADELPHIA,   PA. 


The  New  York  Odontological  Society  held  its  regular  meeting  on 
Tuesday  evening,  April  loth,  1888,  in  the  parlors  of  the  New  York 
Academy- of  Medicine,  No.  13  West  Thirty-first  street. 

The  President,  Dr.  J.  Morgan  Howe,  in  the  chair. 

The  President.  We  will  now  pass  to  the  consideration  of  the  subject 
of  the  evening  : — 

"Metals  and  Other  Materials  for  Filling  Teeth." 

This  is  intended  to  include  a  discussion  of  the  subjects  of  gutta- 
percha and  amalgam,  and  especially  the  papers  of  Drs.  Flagg  and 
Bonwill,  which  there  was  not  time  to  discuss  at  their  reading.  As  Dr. 
Flagg's  paper  was  the  more  recent  and  is  fresher  in  our  minds,  we  will 
consider  that  and  the  subject  of  gutta-percha  first.  I  will  ask  Dr.  Payne 
to  favor  us  with  what  he  has  to  say  on  the  subject  ot  gutta-percha. 

Dr.  E.  T.  Payne.  The  address  delivered  at  our  last  meeting  by 
Prof.  Flagg  would  have  been  more  profitable,  it  appears  to  me,  if  his 
remarks  had  been  formulated  for  a  paper  which  could  have  been  read 
in  forty  minutes  or  one  hour.  Members  could  then  have  asked  ques- 
tions and  brought  out  points  which  would  have  been  instructive,  and, 
I  am  inclined  to  think,  more  profitable  than  the  protracted  talk. 

After  eliminating  the  cavities  where  the  speaker  said  gutta-percha 
was  not  indicated  as  a  desirable  filling  for  permanency,  there  can  be 
no  controversy  as  to  its  being  the  most  permanent  and  useful  filling  for 
the  class  of  cavities  selected  for  its  use.  It  confirms  the  judgment 
of  men  of  experience — nothing  more.  Prof.  Flagg  distinctly  said  he 
did  not  want  the  material  looked  upon  as  a  crutch  to  help  us  over  diffi- 
cult places,  and  spoke  disparagingly  of  Dr.  Atkinson,  who  had  recom- 
mended it  in  that  relation.  His  teaching  in  respect  to  this  point  will 
not  be  accepted  by  those  practitioners  who  have  kept  sensitive,  low- 
toned  teeth  quiet  and  comfortable  with  gutta-percha  until  something 
more  permanent  could  be  used.  If  young  men  do  accept  such  teaching 
they  will  deny  themselves  a  great  help  to  usefulness. 

I  heartily  indorse  all  that  was  said  about,  using  steam  heat  in  pre- 
paring the  filling  for  the  cavity,  and  the  heating  of  instruments  also. 
Too  much  care  cannot  be  taken  in  this  matter.  Heating  any  gutta- 
percha stopping  over  the  flame  of  a  lamp  is  bad  practice,  and  gene- 
rally results  in  more  or  less  injury  to  the  filling.  Dr.  Hill  once  told 
me  he  was  convinced  compax"atively  few  dentists  used  gutta-percha  in 
such  a  way  as  to  obtain  the  best  result.  My  experience  induces  me 
to  indorse  what  he  said  so  many  years  ago. 

Regarding  the  longevity  of  gutta-percha  fillings,  I  want  to  say  that 


undoiibtedlv  it  is  true  that  in  a  few  instances  fillings  made  of  gutta- 
percha remained  in  teeth  twenty  years  or  more.  Prof.  Flagg  left  it  a 
fair  inference  that  the  same  result  would  obtain  now  if  the  case  was 
favorable  and  a  good  quality  of  gutta-percha  was  properly  used.  The 
inference  is  misleading  and   untrue. 

In  a  paper  on  gutta-percha  read  before  this  society  four  years  ago,  I 
stated  that  the  gum  obtained  by  cutting  the  tree  and  scraping  the  inside 
i)f  the  bark  was  much  superior  to  any  obtained  by  tapping.  It  is  to 
that  superior  qualitv  of  gum — which  Dr.  Hill  used  the  first  years  of  his 
experience — that  the  results  so  much  talked  about  are  due.  The  speci- 
mens displayed  by  the  speaker,  both  the  crude  and  that  which  was 
prepared  for  the  teeth,  are  the  product  of  tapping.  Fillings  made  in 
the  best  manner  with  such  material  will  not  last  longer  than  from  two 
to  eio-ht  years.  Verv  few,  indeed,  will  last  more  than  four.  Let  us  not 
deceive  ourselves.  It  cannot  be  depended  upon  as  formerly.  The  reason 
is  the  inferiority  of  the  base.     A  fountain  does  not  rise  above  its  source. 

I  object  to  the  speaker's  position  in  claiming  so  much  for  the  material. 
It  is  very  useful,  and  the  cause  is  weakened  by  claiming  too  much. 
Young  practitioners  should  be  taught  these  facts  instead  of  accepting 
the  fair  inference  from  Professor  Flagg's  remarks  that  if  his  steam-made 
stopping  is  used  all  will  go  well  for  from  five  to  thirty  years.  His  state- 
ment that  red  gutta-perclia  shrinks  more  than  any  other  may  be  proved 
by  test-tubes,  but  mv  experience  proves  that  it  will  last  longer  than  the 
average  stopping.  One  reason  is  it  has  less  foreign  substance  incorpo- 
rated into  it.  Pure  gum  would  outlast  any  other,  and  if  it  co.ild  be 
used  to  advantage,  it  would  be  almost  perfect  as  to  its  lasting  qualities. 
Its  color,  however,  is  objectionable. 

I  repeat  what  I  said  in  my  paper  four  years  ago,  that,  just  in  pro- 
portion as  the  particles  are  separated  by  a  foreign  substance,  just  in 
that  proportion  is  the  substance  weakened  both  in  strength  and  in 
ability  to  resist  the  fluids  of  the  mouth 

We  were  told  by  Prof.  Flagg  that  it  is  our  dutv  to  test  the  material 
before  using  it,  as  one  can  do  so  in  a  few  minutes  in  his  office.  A  little 
farther  on  we  are  told  that  so  difficult  is  an  analysis  of  the  material 
that  it  is  not  known  positively  what  substance  Hill  incorporated  with 
liis  base.  His  statement  that  Hill's  formula  is  unknown,  because  he 
did  not  happen  to  know  it,  is  suggestive  and  amusing,  to  say  the  least. 
There  w;.s  no  intimation  that  gutta-percha  stopping  was  not  in  every 
way  as  good  now  as  it  was  twenty -five  or  thirty  year's  ago  when  Hill 
and  Bevans  were  using  the  gum  before  referred  to.  He  knew,  of 
course,  that  the  best  stopping  in  the  market  to-day  is  very  much  inferior 
to  the  article  which  gave  the  filling  material  its  deservedly  high  repu- 


tation  From  such  a  source  of  learning  and  respectability  we  had  a 
right  to  look  for  the  whole  picture.  His  assertion,  for  instance,  diat  a 
good  stopping  cannot  be  made  without  steam  heat,  porcelain  slabs, 
etc.,  is  a  dogmatic  assumption  which  he  refutes  when  he  further  says 
Hill's  stopping  lasted  thirty  years,  etc.    Hill  never  used  steam  heat. 

From  my  experience  with  the  preparation  of  the  material  I  am  con- 
fident steam  heat  is  better  than  dry  heat  and  kneading-sticks.  But  to 
say  that  good  results  cannot  be  obtained  In  the  old  way  is  not  true.  I 
experimented  all  one  winter  to  make  an  improvement  in  the  texture  of 
the  manufactured  material,  as  there  was  such  an  evident  falling  off  in 
quality,  and  I  found  the  whole  trouble  was  with  the  base.  Until  the 
material  can  be  obtained  as  it  used  to  be,  by  cutting  the  tree.  T  propose 
to  use  the  filling  for  what  it  is  worth,  as  I  find,  it,  not  expecting  too 
much  from  it,  or  what  was  once  realized. 

The  President.  The  next  contribution  to  the  subject  of  the  evening 
will  be  a  paper  by  Dr.  Bogue,  which  he  will  kindly  read  now. 

Dr.  E.  A.  Bogue  then  read  the  following  paper,  entitled  : — 

"Filling  Materials  and  Methods," 

in  which,  after  referring  to  materials  and  methods,  he  continued  as 
follows  : — 

'•  I  think  we  all  owe  our  thanks  to  Dr.  Flagg  for  his  late  discourse 
on  gutta-percha,  and  especially  for  the  clear  way  in  which  he  has 
defined  the  class  of  cases  where  its  use  as  a  filling  for  decayed  teeth  is 
indicated.  His  enthusiasm  leads  him  to  say  some  things,  however,  that 
ought  to  be  challenged.  If  he  is  right,  it  can  be  proven  ;  if  wrong,  it 
is  the  function  of  this  society  to  point  it  out. 

'■As  one  person,  I  regret  that  Dr.  Flagg  felt  it  necessary  to  excuse 
himself  for  the  exclusive  use  of  plastics,  or  that  he  cited  the  f\ict  of  his 
presence  before  this  societ}-  as  an  '  evidence  that  he  had  maintained  his 
respectability.'  He  ought  not  to  need  any  such  evidence.  It  has  been 
the  maxim  of  this  society  to  'prove  all  things,  and  hold  fast  that  which 
is  good.'     So  all  men  having  ideas  to  present  have  been  welcomed. 

"It  has  been  Dr.  Flagg's  efibrt  for  more  than  twenty  years,  of  my 
personal  knowledge,  to  save  teeth  that  many  other  practitioners  would 
extract  The  good  that  he  has  accomplished  commands  sincere  respect ; 
but  I  cannot  say  as  much  for  some  of  his  statements  and  some  of  his 
methods.  I  regret  to  hear  such  words  as  these  :  'I  want  to  induce  you 
to  try  these  things,  for  certainly  you  must  understand  that  you  know 
little  or  nothing  about  plastic  fillings.  You  may  have  been  told  that 
my  practice  is  among  the  rag-tag  and  bob-tail  from  the  gutters  of  Phila- 
delphia, but  you  know  very  well  that  my  patients  are  among  the  very 


best,  the  most  intelligent,  and  the  most  weaUhy  of  the  people  of  that 
city,  and  are  typical  individuals  of  their  class  ;  and  yet  they  are  perfectly 
satisfied  with  the  work  I  do  for  them.' 

"Comforting  tlie  declining  years  of  aged  people,  even  if  they  are 
millionaires  or  members  of  the  best  society,  by  preserving  their 
natural  teeth,  using  the  gentlest  possible  means,  whether  those  means 
be  gutta-percha  or  amalgam,  is  praiseworthy.  But  can  we  denominate 
as  praiseworthy  and  strictly  scientific  a  sentence  like  this :  '  If  /  do 
not  know  when  it  is  best  to  extract  a  tooth,  I  do  not  know  which  of 
you  does.'  Or  a  question  so  misleading  as  this:  'If  you  place  your 
gutta-percha,  properly  prepared,  where  little  or  no  wear  can  come  upon 
it,  in  such  wise  that  you  know  just  as  well  as  you  know  anything  that 
a  zinc-phosphate  filling  would  not  have  lasted  two  little  years,  a  gold 
filling  would  not  have  lasted  five  years,  an  amalgam  filling  would  not 
have  lasted  more  than  ten  years,  and  your  gutta-percha  filling  lasted 
fifteen  years, — then  I  ask  of  you  if  gutta-percha  properly  used  is  not 
the  most  permanent  filling  material  we  possess.'''  Dr.  Flagg  leads  up 
to  an  answer  which  he  seems  to  desire,  but  it  should  be  recognized  that 
his  premises  are  not  generally  to  be  admitted  without  question,  hence 
his  inferences  are  often  fallacious.  Ver}'  few  men,  except  Dr.  Flagg, 
have  seen  many  gutta-percha  fillings  fifteen  years  old,  and  Dr.  Flagg 
himself  is  greatly  elated  by  coming  across  such  fillings.  In  such  cases, 
undoubtedly  it  was  the  best  material. 

"  But  when  Dr.  Flagg's  next  sentence  asserts  interrogativelv  thac 
gutta-percha,  properly  used,  is  the  most  permanent  filling  we  possess, 
I  think  his  enthusiasm  would  make  his  hearers  infer  more  than 
he  actually  means  ;  particularly  when  he  continues  by  saying,  'I  want 
to  leave  with  you  to-night  the  impression  that  you  can  work  gutta- 
percha precisely  the  same  as  you  work  cohesive  gold.'  Yet  farther  on 
he  admits  the  value  of  copper  amalgam  in  desperate  cases.  Dr.  Flago- 
counsels  us  to  '  have  our  gutta-percha  tested,  so  that  we  know  exactly 
what  it  is  composed  of  and  the  proportions  of  it,"  and  he  says  ''any 
man  can  test  it  in  ten  minutes  in  his  office.'  Three  minutes  later  Dr. 
Flagg  says:  '  We  have  known  positively  for  half  a  century  that  Hill's 
gutta-percha  stopping  was  not  made  of  quicklime  and  silex,  but  do  not 
know  what  it  was  made  of.  So  difficult  is  its  analysis  that  we  have 
not  been  able  to  say  positively  what  Dr.  Hill  made  his  stopping  of  A 
little  later  in  his  address  Dr.  F.  says  :  '  The  only  way  for  you  to  use 
gutta-percha  successfully  is  to  test  the  various  materials  before  putting 
them  into  the  mouth.     It  is  the  work  of  a  life-time.' 

"'Ten  minutes'  have  lengthened  into  '  half  a  century,'  and  half  a 


5 

century  into  a  life-time  very  quickh' — but,  as  Dr.  Flagg  says  he  tells 
'the  truth,  the  whole  truth,  and  nothing  but  the  truth,'  we  must  seek 
to  reconcile  these  conflicting  statements  as  best  we  may. 

"  Dr.  Flagg  says  next :  '  I  do  not  want  my  material  to  be  looked 
upon  as  a  crutch.'  He  will,  it  is  hoped,  pardon  the  suggestion  that 
this  society  was  not  aware  that  gutta-percha  was  a  proprietary  article, 
and  it  must  regard  all  subjects  brought  before  it  as  absolutely  free  for 
discussion.  Dr.  Payne  asked  how  Dr.  Flagg  accounted  for  the  protec- 
tion of  the  tooth  against  decay  when  the  shrinkage  of  a  gutta-percha 
filling  necessarily  admits  more  or  less  moisture  to  the  cavity,  when  dis- 
integration of  tooth  would  ensue  if  a  gold  filling  leaked.''  (Please 
notice  Dr.  Payne's  admission  of  the  correctness  of  the  general  belief 
that  a  leaky  gold  filling  will  allow  disintegration  of  tooth-substance 
around  it.)  Dr.  Flagg  I'eplied  that  the  gutta-percha  was  a  non-con- 
ductor of  galvanic  or  electric  currents,  and  that,  the7'efore^  no  chemical 
action  takes  place  between  the  gutta-percha  and  the  tooth-bone.  He 
sa3s  the  only  action  that  can  take  place  is  the  leakage  of  moisture. 

"  Dr.  Flagg,  speaking  of  amalgams,  says  that  '  amalgam  permits 
moisture  to  do  good.'  He  claims  to  recognize  that  fact,  and,  therefore, 
says  that  '  amalgams  that  do  not  shrink  are  not  as  good  tooth-savers  as 
amalgams  which  shrink.'  He  has  much  to  say  about  tooth-savers, 
meaning  fillings  His  practice  necessarily  leads  to  inaccuracies  both  in 
excavation  and  in  adaptation  of  filling  materials.  He  has  invited  the 
worst  class  of  cases  and  the  worst  class  of  teeth.  As  it  would  be  a 
physical  impossibility  to  use  gold  in  most  of  those  cases,  Dr.  Flagg  has 
elected  to  use  plastics  in  all  of  them.  The  results  obtained  are  the 
sum  of  his  experience.  This  experience,  though  strictly  empirical,  is 
most  valuable,  but  it  does  not  justify  any  one  in  dogmatic  assertions 
that  he  cannot  prove.  All  this  galvano-electric  current  assertion  comes 
under  that  head. 

"If  Dr.  Flagg  could  be  induced  to  answer  concisely,  according  to  his 
knowledge,  he  would  agree  that  the  causes  of  decay  in  teeth,  leaving 
out  of  view  heredity,  which  would  have  to  do  with  form  and  position, 
may  be  summed  up  in  ver}^  few  words,  viz.  :  that  which  causes  solu- 
tion. Now,  solution  of  the  enamel  never  takes  place  at  any  point 
where  it  is  exposed  to  friction,  but  only  in  such  spots  or  crevices  as 
favor  the  retention  of  foreign  substances  which,  under  the  combined 
influences  of  heat,  moisture  and  atmospheric  contact,  speedily  produce 
disintegrating  acids  in  a  nascent  condition.  The  experienced  dentist 
knows  full  well  where  to  look  for  dental  decay.  The  smaller  the 
crevice  the  longer  it  takes  for  the  enamel  to  break  down,  but  Dr. 
McQuillen  showed  many  years  ago  how,  between  two  plates  of  sound 


f, 

enamel,  the  substances  that  produce  decay  may  reach  the  dentine,  and 
so  largely  disintegrate  it  as  to  cause  almost  total  destruction  of  the 
crown  before  the  patient  is  conscious  of  disease.  How,  then,  can  we 
be  told  that  leakage  is  a  benefit?  How  can  those  amalgams  that  con- 
tract be  vaunted  as  the  best?  How  can  gutta-percha  be  regarded  as 
anything  else  than  a  valuable  adiunct  to  our  various  filling  materials? 

"We  must  necessarily  challenge  the  statement  that  'amalgams  that 
do  not  shrink  are  not  as  good  tooth-savers  as  amalgams  whichs  brink/ 
for  both  palladium  and  copper  are  recognized  as  being  the  best  pre- 
ventives of  decay  among  all  the  amalgams,  yet  these  two  do  not  shrink. 
Dr.  Flagg  himself  counsels  copper  amalgam  in  desperate  cases. 

"  Dr.  Flagg  goes  on  to  say  :  '  In  five  minutes  you  can  tell  whether  an 
amalgam  will  shrink  or  not.'  This  is  absolutely  incorrect  in  regard  to 
any  strange  or  new  amalgam.  I  have  tested  several  amalgams  that 
have  continued  to  change  their  form  for  several  days,  sometimes  shrink- 
ing, sometimes  expanding. 

"I  think  Dr.  Flagg  scarcely  meant  that  he  could  ascertain  in  thirty 
minutes  the  composition  of  a  new  amalgam  ;  still  less  its  quantitative 
composition.  Yet  one  might  infer  that  from  his  saying  that  he  could 
ascertain  its  composition  in  thirty  minutes. 

"  In  advocating  gutta-percha  for  front  teeth,  Dr.  Flagg  failed  to  state 
that  this  material  often  becomes  so  dark  on  the  surface  as  to  be  more 
unsightly  than  many  amalgams,  and  always  changes  color,  becoming 
fluffy  or  soiled. 

"  Having  thus  called  attention  to  a  few  of  the  inconsistencies  and 
errors  in  Dr.  Flagg's  address,  I  beg  to  call  attention  to  another  portion 
of  that  same  address  which  contains  the  most  precise,  accurate  and 
concise  description  of  where  and  when  to  use  gutta-percha  that  I  have 
ever  heard:  'Gutta-percha  is  not  presented  as  a  material  suitable  for 
all  sorts  of  cavities,  but  only  those  having  circumscribed  walls — com- 
paratively round,  shot-hole  cavities  in  the  buccal,  distal  and  mesial 
surfaces  of  teeth,  not  on  the  articulating  surfaces;  where  the  cavity  is 
small  on  the  outside  and  large  on  the  inside,  and  where  the  tooth  is 
soft,  of  frail  structure  and  highly  organic  ;  such  cavities  as  would  be 
prepared  for  gold  filling  by  cutting  away  all  the  surrounding  enamel 
walls  until  you  get  to  strong  walls — in  filling  such  cavities  with  gutta- 
percha you  conserve  the  enamel  structure  all  that  you  possibly  can.'  If 
you  add  frail  and  loose  teeth  and  badly  leaning  ones  to  this  categoi'y,  it 
epitomizes  the  best  features  of  the  paper." 

***** 
Dr.  Ferry.      One   good  result  of  Dr.   Flagg's  lecture   is  the   most 


excellent  paper  that  we  have  just  listened  to  from  Dr.  Bogue.  I  am 
in  accord  with  almost  every  sentiment  that  he  has  uttered  on  that  sub- 
ject. 


REPLY. 


"IN  ABSENTIA." 

BY  J.    FOSTER   FLAGG   D.  D.  S.,    PHILADELPHIA,    PA. 


Honors  conferred  in  this  fashion  are  sometimes  creditable  and  some- 
times discreditable  alike  to  donors  and  recipients.  If  creditable,  then 
all  is  well,  but  if  discreditable,  either  to  donors  or  recipients,  then  all 
is  not  well. 

At  the  meeting  of  the  New  York  Odontological  Society,  held  Feb- 
ruary 14th,  1888,  I  had  the  pleasure  of  speaking  in  behalf  of  gutta- 
percha stopping,  and,  after  two  months  had  passed,  at  a  meeting  of  the 
same  Society,  held  April  loth,  1888,  reported  in  July  Cosmos^  p.  475, 
Drs.  E.  T.  Payne,  and  E.  A.  Bogue  gave  utterance  to  comments  upon 
my  effort  which  are  so  discreditable  to  themselves,  and  which,  if  true, 
would  be  so  discreditable  to  me  that  I  deem  it  my  duty  to  reply  at  once. 

First,  for  Dr.  Payne  ;  I  do  not  admit  that  my  effort  would  have  been 
more  profitable  as  a  paper  than  it  was  as  an  address,  and  I  judge  of 
this  matter  from  the  expressions  of  opinion  as  to  its  value  which  were 
given  me  by  voice  upon  that  occasion  and  which  have  been  repeated 
by  scores  of  letters  received  since. 

As  for  members  asking  questions,  I  think  the  report  in  the  Costnos 
for  May  indicates  that  the  questioning  was  pretty  lively. 

I  wish  to  antagonize  more  emphatically  than  ever,  if  possible,  the 
"  crutch"  idea  as  applied  to  gutta-percha  and  to  insist  upon  just  that 
degree  of  longevity  for  fillings  of  this  material  that  I  have  always 
assumed,  viz.  from  twice  to  thrice  the  durability  of  gold  when  used 
instead  of  gold  in  places  which  are  frequently  filled  with  gold  and 
which  should  be  filled  with  gutta-fercha . 

I  deny  the  assertion  that  fillings  made  of  the  gutta-percha  stoppings 


of  the  present  day  are  inferior  to  those  of  former  times;  and  the  state- 
ment made  by  tlie  gentleman  that  such  fillings  will  not  last  longer  than 
from  two  to  eight  years,  merely  because  he  does  not  happen  to  know 
any  better,  is  ''suggestive  and  amusing,  to  say  the  least." 

I  have  hundreds  of  such  fillings  made  from  such  gutta-percha  which 
are  now  more  than  ten  years  old  and  wiiich,  with  the  exception  of  very 
trifling  wear,  are  as  good  as  when  introduced  and  which  are  saving  the 
soft,  frail  teeth  perfectly. 

In  my  experience  the  average  of  well  introduced  good  gutta-percha 
work  of  the  last  decade  is  equel  to,  if  not  superior  to,  that  of  thirty 
years  ago;  therefore,  the  inference  that  such  results  are  obtained  is 
neither  "  7nisleading"  nor  "  untrue." 

It  is  true  that  I  did  say  that  it  was  a  duty  that  operators  should 
"test"  their  gutta-percha  stopping,  that  from  such  "testing"  might  be 
known  the  approximate  degree  of  heat  at  which  it  softens  (as  I  ex- 
pressed it,  "  its  heat-grade")  and  also  exactly  its  composition,  (as  I  ex- 
pressed it,  '■^  just  the  proportions  of  organic  and  inorganic  Tnatter  ") 
and  it  is  equally  true  that  I  said  that  an  analysis  was  a  very  difficult 
piece  of  work,  and  the  attempt  to  make  a  point  on  these  two  assertions 
merelv  because  the  gentleman  did  not  happen  to  know  the  difference 
in  gutta-percha  work  between  "testing"  and  ''analysing"  is  "sugges- 
tive and  amusing,  to  say  the  least." 

Regarding  my  assertion  that  the  formula  for  ''Hill's  stopping,"  is 
unknown,  I  would  say  that  I  have,  during  tiie  past  twenty-five  years, 
embraced  every  opportunity  to  ask  those  of  our  profession  from  whom 
I  deeined  it  possible  I  might  obtain  information  as  to  the  formula  of 
this  (at  first)  excellent  material,  and,  in  every  instance  I  was  told  by 
each  individual  that  he  "did  not  know." 

It  was  from  this  fact  that  I  said  that  our  information  was  "  t?ieagre  !" 

And  now  I  would  ask  further  if  Dr.  Payne  was  a  student  with  Dr. 
Hill,  and  if  he  made  some  ot  that  material,  and  if  he  knew  of  what 
it  was  composed  and  what  were  the  proportions^  why  has  he  not 
published  all  this  long  ago.'* 

He  tells  us  that  if  we  used  any  of  Hill's  stopping  of  twenty-five  years 
ago  we  used  that  which  he  made  ;  but  if  my  recollection  serves  me,  it 
was  just  about  that  time  that  the  quality  of  Hill's  stopping  com- 
menced inarkedly  to  deteriorate.  This  might  have  been  merely  coin- 
cidental, but  the  reminiscence  is  "suggestive  and  amusing,  to  say  the 
least." 

That  he  thinks  he  knows  I  do  not  doubt,  but  that  he  knows  I  regard 
as  an  open  question,  and  if  it  could  be  proven  by  analysis  that  he 


thought  he  knew,   but  did  not,  it  would  also  be   "  amusing,  to  say  the 
least." 

Students  oftentimes  think  they  know. 

I  do  not  see  by  what  authority  the  gentleman  states  that  /  know,  "of 
course,  that  the  best  stopping  in  the  market  to-day  is  very  much  inferior 
to  the  article  which  gave  the  filling  material  its  deservedly  high  repu- 
tation," for  I  do  not  know  any  such  thing. 

The  gentleman  speaks  of  Hill's  and  Bevans'  stoppings,  but  my 
record  of  gutta-percha  work  was  not  made  with  either  of  these.  I  could 
not  speak  for  gutta-percha  with  views  based  upon  that  material  as 
given  us  "twenty-five  or  thirty  years  ago." 

I  refer  to  the  gutta-percha  of  the  last  twenty-five  years,  with  its 
gradual  improvement  in  lessened  quantity  of  inorganics  with  mainte- 
nance and  increase  of  heat-grade ;  with  its  improved  toughness  and 
with  its  improved  working  qualities. 

If  the  gentleman  is  not  aware  that  as  crude  gutta-percha  has  deteri- 
orated, gutta-percha  stopping  has  nobly  held  its  own,  he  should  post 
himself  before  speaking,  because  "from  such  a  source  of  learning  and 
respectability  we  have  a  right  to  look  for  the  whole  picture." 

And  so,  because  Hill  never  used  steam  heat,  the  statement  that  it  is 
essential  to  use  it  now,  is  a  "  dogmatic  assumption  !  " 

Hill  had  the  crude  gutta-percha  of  the  cut-down  trees.  We,  of 
to-day,  have  only  the  crude  gutta-percha  of  the  tapped  trees — therefore, 
Hill  could  dispense  with  that  care  and  nicety  of  manipulation  which 
we  of  to-day  find  essential  to  the  production  of  an  acceptable  result. 

It  seems  to  me  that  to  assume  that  my  assertion  was  a  dogmatic 
assumption  is  itself  a  dogmatic  assumption  ! 

The  gentleman  states  that  he  "experimented  all  one  winter"  to 
improve  the  texture  of  the  manufactured  material,  but  he  found  the 
whole  trouble  was  with  the  base. 

I  have  been  systematically  experimenting  for  the  same  purpose  for 
more  than  twenty  years,  and  I  feel  that  I  have  been  rewarded  for  mv 
labor,  which,  however,  would  only  seem  to  indicate  that  I  can  do  more 
in  twenty  years  than  the  gentleman  can  in  "one  winter" — which  I 
guess  is  true  ! 


Second,  for  Dr.  Bogue  ;  after  having,  in  a  paper  on  "Filling  Mate- 
rials and  Methods,"  asked  questions,  given  answers  and  drawn  deduc- 
tions just  such  as  would  have  been  accepted  twenty  years  ago,  but 
which  I  think  would  be  seriously  questioned  in  discussions  of  the  pre- 


10 

sent  dav,  the  gentleman   kindly  covers  me  over  with  dental  sweetness 
and  tlien  swallows  me  ! 

Truly  Bogiie-ish — and  as  such  a  position  is  not  agreeable  to  me  I 
shall  strive  to  bring  about  a  repetition  of  the  history  of  Jonah  and  the 
whale. 

The  jaws  open  with  this,  as  if  quoting  from   me  :  "  I  regret  to  hear 
such  woids  as  these,  'I  want  to  induce  you  to  try  these  things,  for  cer- 
tainly   vou  must  understand  that   you   know    little  or    nothing    about 
plastic  fillings.'  " 
I  never  said  so  ! 

\Vliat  I  said  was  this,  as  reported:  "I  want  to  induce  you  to  try 
these  things,  for  certainly  you  must  understand  that  from  such  stand- 
points as  I  offer  here  to-night  you  KXOW  little  about  plastic  fillings," 
which  sentiment,  I  think,  would  not  be  cavilled  at  by,  at  least,  a  ma- 
jority of  those  present,  and  I  firmly  believe  would  be  most  decried  only 
by  those  least  informed. 

The   jaws  again  open   wider    with  this:   "Can    we    denominate    as 
praiseA'orthy  and  strictly  scientific  a  sentence  like  this,  '  If  /  do    not 
know  when  it  is  best  to  extract  a  tooth,  I  do  not  know  which  of  you 
does,'  "  as  if  quoted  from  me  !  ! 
I  never  said  so  ! 

In  speaking  of  banding  together  loose  and  shaky  teeth,  I  said:  "It 
lias  been  said  that  teeth  in  this  condition  had  better  be  extracted.  Is  it 
best?  And  if  /  do  not  know  when  it  is  besc  to  extract  a  tooth,  I  ask 
you  who  of  you  does.'"' 

Siinply  a  question,  and  no  assertion.  I  do  not  see  that  seeking 
information  is  2/«-praiseworthy,  or  that  the  position  or  question  was 
absolutely  z<«-scientific. 

Again,  the  gentleman  insinuates  that  I  advocate  the  use  of  gutta- 
perclia  "precisely  as  I  would  use  cohesive  gold!"  and  he  kindly  calls 
that  "  enthusiasm  "  when  the  context  of  the  report  will  show  that  in 
truth  I  was  speaking  against  that  kind  of  use  of  gutta-percha  which 
would  be  likely  to  result  from  tlie  idea  that  it  was  a  temporary  filling; 
then  it  was  that  I  said  that  I  wanted  "to  leave  with  you  to-night  the 
impression  that  you  can  work  gutta-percha  precisely  the  same  as  you 
work  cohesive  gold,"  meaning  carefully,  with  accuracy,  and  with  the 
idea  that  with  such  work  it  would  be  compensatingly  permanent ;  and 
this,  /  have  reason  to  believe.,  was  generally  and  thoroughly  so 
understood. 

The  gentleman  next,  by  a  series  of  gyrations  and  one  utter  misquota- 
tion, lengthens  '"ten  minutes"  into  "half  a  century"  (not  the  slightest 
connection  between  the  statements  except  the  placing  of  them  together 


11 

by  the  gentleman  !)  and  the  half  century  into  a  life-time,  thus  giving 
"  not  the  truth,  nor  any  part  of  the  truth,  but  everything  but  the  truth  " 
in  contradistinction  to  my  usual  method. 

In  "testing"  gutta-percha  the  aim  is  to  find  out  txuo  things — the 
relativity  between  the  organic  and  inorganic  comiDonents,  and  the 
"  heat  grade  "  of  the  material  tested — with  these  two  factors  one  versed 
in  gutta-percha  can  tell  much  as  to  the  qualitv  of  his  material — for 
those  who  do  not  know  the  diflerence  between  •■  testing"  and  •■  ana- 
lyzing" it  does  not  tell — much  ! 

"Testing"  can  be  done  in  ^"^  ten  mimites." 

The  gentleman  then  mixes  the  next  two  quotations  and  draws  his 
deduction  with  a  child-like  innocence  wdiich,  for  New  York,  is 
refreshing  ! 

He  says  that  /  say  :  '•  The  only  way  for  you  to  use  gutta-percha  suc- 
cessfully is  to  test  the  various  materials  before  putting  them  into  the 
mouth.     It  is  the  work  of  a  life-time  "!!!!!!! 

The  admiration  marks  are  mine,  but  I  could  not  help  putting  them 
there,  for  again, 

I  never  said  it ! 

After,  as  he  quotes,  urging  the  "testing"  of  the  various  materials 
.(gutta-percha  stoppings)  before  putting  them  in  the  mouth,  I  said  : 
"The  testing  of  the  value  of  the  various  inorganics  is  the  work  of  a 
life-time." 

The  whole  range  of  amalgam  remarks  in  which  the  gentleman 
indulged  are  so  indicative  of  utter  superficiality  that  I  shall  simply  pass 
them  over  as  beneath  my  notice,  merely  intimating  that  his  testing  of 
'•amalgams  that  have  continued  to  change  their  form  for  several  days, 
sometimes  shrinking,  sometimes  expanding,"  is  probably  about  as  valu- 
able and  reliable  as  was  his  "  little  bottle  and  warm  water  bath  "  experi- 
ment to  determine  whether  or  no  amalgam  fillings  would  produce 
mercurial  ptyalism  ! 

But  when  the  gentleman  not  only  misquotes  me,  but  italicizes  the 
word  I  NEVER  USED  to  give  point  to  his  assertion,  I  think  it  time 
that  I  should  strongly  denounce  such  unworthy  and  despicably  unsci- 
entific conduct. 

He  says  that  /  said  :  "I  do  not  want  my  material  to  be  looked  upon 
as  a  crutch,"  and  comments  upon  this  as  follows;  "He  will,  it  is 
hoped,  pardon  the  suggestion  "  (how  velvety  soft  is  the  odious  phrase- 
ology !)  "  that  this  society  was  not  aware  that  gutta-percha  was  a  pro- 
prietary article,  and  it  must  regard  all  subjects  brought  before  it  as 
absolutely  free  for  discussion." 

I    NEVER    SAID    SO  ! 


12 

After  referring  to  Dr.  Atkinson's  former  endorsement  of  gutta- 
percha as  a  "  crutch,"  what  I  did  say  is  this — "  I  do  not  want  it  to  be 
welcomed  on  anv  such  terms  as  that.  I  do  not  want  this  material  to 
be  looked  upon  as  a  crutch.  I  wish  it  to  be  looked  upon  as  a  reliable 
friend  in  need  I" 

Thus  it  will  be  seen  that  as  no  "  proprietary  "  word  or  thought  was 
indulged  in  bv  me.  all  his  Mephistophilish  sarcasm  falls  harmlessly  to 
pieces  from  its  own  rottenness,  as  it  has  not  the  slightest  foundation 
in  truth  to  rest  upon  I 


Ex'.raci  jrom  Odonlological  Society  Report,  p.  4S7,  July  Cosmos. 

The  President.  Gentlemen,  we  have  Dr.  Niles,  of  Boston,  with  us  to-night,  and  we 
would  be  glad  to  hear  from  him. 

Dr.  E.  S.  Niles.  This  is  too  great  a  subject  for  one  10  speak  upon  impromptu.  We 
have  considered  the  subject  of  amalgam  in  the  American  .\cademy  of  Dental  Science 
for  the  last  two  meetings,  and  I  must  say  that  the  result  of  the  di.ccussion  is  rather 
unsatisfactory.  In  fad,  the  present  information  on  the  subject  discourages  me  in  the 
use  of  amalgam.  I  now  speak  exclusively  of  copper  amalgam.  Since  I  have  been  in 
practice,  I  have  been  more  or  less  dissatisSed  with  these  fillings,  as  I  think  we  all 
have,  and  have  looked  forward  to  some  day  when  I  might  take  up  the  subjecl  for  the 
purpose  of  making  some  saiisfaclory  ex[>eriraents.  I  regard  the  present  investigation 
of  amalgams  as  superficial,  for  the  reason  that  when  we  speak  of  amalgams  we  may 
refer  to  any  number  of  compounds,  all  of  which  may  vary  in  their  composition. 

Etc.,  etc.  for  a  page  or  more  of  remarks  all  of  which  seem  to  indi- 
cate that  when  the  gentleman  has  "experimented"  he^  perhaps  (.''). 
will  know  more  of  the  '■  great  "  subject  upon  which  he  is  tr\ing  to  speak. 

He  next  continues  as  follows:  "I  was  going  to  say  in  regard  to  the  distinguished 
professor  who  addressed  this  society  at  its  last  meeting,  that  I  am  sorry  he  d'^es  not 
lell  us  fully  and  conclusively  of  what  his  compounds  are  composed,  and  in  a  way  that 
would  enable  us  to  make  similar  preparations  for  ourselves.  I  am  sorry  to  say  that 
such  is  not  the  case,  as  ray  own  experiments,  as  well  as  the  experiments  of  my 
brethren  in  Boston  and  other  cities  have  proved.  Some  years  ago,  while  attending 
school  in  Philadelphia,  I  boarded  not  far  from  Dr.  Fiagg's.  and  we  used  to  have  on  the 
table  what  the  mistress  was  pleased  '.0  call  'scrapple.^  I  was  very  much  interested 
to  know  of  what  it  was  composed,  and  was  told  it  was  made  of  bits  that  came  from 
ttie  table,  into  which  she  pat  eggs,  pepper  and  various  things.  It  might,  therefore,  be 
made  of  one  thing  one  day.  but  of  entirely  different  things  the  next.  In  reflefting 
upon  this  subject  I  have  wondered  whether  the  making  of  mysterious  comoounds  in 
Philadelphia  was  confined  to  the  manufacture  of  'scrapple'  alone,  or  whether  other 
combinations  in  that  city  may  not  have  a  similar  origin. 

"As  long  as  the  profession  consent  to  use  alloys  the  composition  of  which  they  are 
not  familiar  with,  no  complaint  can  be  entered  against  those  who  make  amalgams  or 
■  scrapple '  alloys." 

What  a  powerful  reflector  ! 

From  his  not  knowing  "  fully  and  conclusively  "  of  what  my  com- 
pounds are  composed  it  is  evident  that  he  has  not  read  •''  Plastics  and 
Plastic  Filling,"  in  which  work  he  would  find  just  what  *'  bits  that 


13 

come  from  the  table  "  are  best  adapted  for  each  particular  kind  of 
'•'•  scrapple  y 

When  it  is  remembered  that  -''scrapple'  is  a  compound  of  Indian 
meal  and  pork  scraps  (hence  its  name)  it  would  seem  that  some  Phila- 
delphia wag  was  playing  upon  the  credulity  of  the  scholar  from  Bos- 
ton^ whose  thirst  for  knowledge  would  evidently  have  been  satisfied 
with  the  information  that  "  fish  balls''  were  composed  of  chicken  and 
turnips. 

And  when  it  is  also  remembered  that  the  scholar  from  Boston  is 
the  gentleman  who  conferred  upon  dentistry  the  inestimable  boon  of 
the  "hermetically  sealed  tubes"  for  the  maintenance  of  the  integrity 
of  phosphoric  acid  menstruum  just  two  years  after  it  had  been  experi- 
mentally proven  a7id  taught  that  such  menstruum  "changed"  practi- 
cally at  the  same  time,  whether  kept  in  hermetically  sealed  bottles,  ordi- 
narily stopped  bottles,  or   in  vjide  mouthed  vessels  open  to  the  air'. 

And  when  he  is  further  recognized  as  the  author  of  the  exciting 
Newark  anecdote  of  the  young  lady  who  asked  him  ''  if  he  was  from 
Boston?"  to  which  he  replied  that  he  '  was  from  Boston,"  to  which 
she  replied  that  she,  'also,  was  from  Boston" — so  they  were  both 
from  Boston',  it  goes  without  question  that  to  repel  an  attack  from 
such  a  source  would  be  merely  to  inaugurate  another  ''  Mosquito  War  !  " 


I  visited  New  York  in  the  acceptance  of  cordial  and  repeated  invita- 
tion ;  I  took  with  me  for  presentation,  the  carefully  prepared  results  of 
many  years  of  conscientious  endeavor  to  add  to  the  resources  of  our 
profession  in  its  work  of  doing  good. 

I  was  unconscious  of  having  either  thought,  said  or  done  anything 
which  was  other  than  interesting,  instructive  and  acceptable. 

I  was  not  only  congratulated  and  thanked  upon  that  occasion,  but  I 
have  since  received,  from  there,  several  written  acknowledgments  of 
interest  and  satisfaction. 

I  am  accustomed  to  personal  abuse,  and  I  have  always  striven  to 
live  above  it,  but  I  must  openly  and  decidedly  protest  against  such 
comments  and  papers  as  those  of  Drs.  Payne  and  Bogue,  which  with 
impertinent  assurance  accredit  me  with  views  which  I  do  not  hold  ; 
with  knowledge  which  I  do  not  acknowledge,  and  with  fallacious 
deductions  from  what  might  be  admitted  if  I  "could  be  induced  to 
answer  concisely  !" 

And  I  must  also  say  that  I  was  not  prepared  to  find,  as  I  did  from 
the  April  proceedings,  that  I  was  not  only  left  alone  to  fight  for  myself 


14 

(wliich,  I  am  thankful  I  feel  completely  able  to  do.)  but  such  vile 
ertbrt  was  characterized  as  "  excellent !  " 

Candid,  fair  and  honorable  criticism  of  my  views  1  have  always 
earnestly  invited,  and  when  by  time  or  argument  I  have  been  proven 
in  the  wrong  I  have  always  cheerfully  and  thankfully  acknowledged  it. 

But  when  malicious  sneers,  deliberately  concocted  mis-statements  and 
italicized  perversion  of  the  truth  are  returned  for  kindly  effort,  I  think 
the  right  will  be  conceded  me  to  feel  that,  hi  certain  degree^  I  have 
been  foolishly  ''casting  pearls  before  swine." 


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